Part 5

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Seems like a lot of stories are adding up. If you have come this far there is no turning back. The pages keep turning. Enjoy!

It seems fitting to write a piece about the old house now a decade has past. It was the venue for multiple unique episodes in my life and the formative years of my children’s youth. It was also this time a decade ago I found myself in another tough spot seeing it all end. When one door closes another opens the old saying goes. Seems more like I close one door on Memory Lane and open another into the House of Mirrors. However, the house once called home should definitely be memorialized. 

The purchase of the house itself seemed initially like a feather in my cap. The failure of my insurance and financial planning career, the subsequent bankruptcy and the fights with the in-laws were behind me. It was 2002. The house also signified I put our young family back on track. The road might have been rocky but indeed my plan worked. Filing bankruptcy, going back to work as an $8 an hour, plus commission, telemarketer at MCI/WorldCom played out perfectly. The lawyer was correct; once the non secured debt was extinguished through chapter 7 bankruptcy the banks realize the cash flow just improved so the process playing the credit game begins again. No debtors prison and no fines for simply being a financial idiot or failed business attempt. Two years later the new house personified I was correct. The material possessions feed the ego.
 

At MCI/WordCom on 3rd street in Cedar Rapids there were probably 200-300 different employees in various positions. The entire building contained a handful of people with a college degree. MCI/Worldcom’s employees more resembled the guys I mess cranked with in the navy than representatives of a publicly traded company. Whatever, I was good at phone sales. I got a promotion to a supervisor. In two years I was up to $50,000 a year, no debt and the credit score went up to 720 qualifying for a standard rate mortgage. I could have used the no money down loan through the VA again but the bank said I didn’t need to. From crash and burn to a brand new home in two years for the new family. Everyone raised their eyebrows but still had faith in my resilience…. except the in laws, of course.
 

The problems began no sooner than the ink dried on the mortgage. The builder of the home talked a nice game when he sold us the home. Nowhere to be seen when I wanted the lawn replaced because they threw down the sod on the hottest days and failed to water it adequately before we moved in. The garage door wouldn’t close because it was put in incorrectly. I called a few times but the call was never returned. Sorry, Bozo. Wrong guy. He was Johnny on the spot before the sale. I made a sign and put it in the front yard that said “Home For Sale. Shitty Construction. Built by his company 555-1212.” Everyone driving by looking at the other houses being built saw my sign. He called before the sun set and was pissed. Nope, sign stays up. Get your boys out here and replace the lawn. Lawn replaced and door fixed next day free of charge. This was the tip of the iceberg.

First, the house itself was not in the preferred Prairie school district the ex wife wanted. She was correct in the desire to put the kids in the better school district. She just came up short on the homework regarding the boundary lines for the district. We found out the hard way there would be no school bus taking the kids to school and picking them up for open enrollment in the upcoming years. Someone would have to be the duty driver for years or we would have to find a new house immediately. We opted to stay. Shortly after that, the rains came.
 

Next, was the disastrous house warming party. A friend of mine’s new wife got shit faced drunk and called me an asshole before she passed out at the house. My friend was pretty embarrassed. This would have been clue one to end the party, but no. We decided to go to the strip bar, with ex wife included. I told her not to go but she insisted she had always wanted to go to one. Whatever, she went along. Huge mistake. I took a seat with my buddies up front on Sniffers Row and my ex went to the restroom. We were there a total of five minutes. I had not even got my beer when my drunk ex noticed me staring at a stripper. Out of nowhere a cheap shot slap right across the face. I thought it was a drunk idiot so stood up and was ready to swing only to see my pissed off and jealous wife almost in tears. All the guys started laughing. It was quite humiliating. We left immediately. Talk about an awkward next morning.
 

The rains continued and soon came the first flooded basement. It was a memorable event. The truth is the homes in the cul de sac should not have been built in the area as it was a former drainage field that had clay tiling run throughout the entire area. It sits on the windward side of Wilson Ave. The rainwater from the slope on the hill pools and drains in the cul de sac by poor design. All the neighbors at a slightly higher elevation also had their down spouts headed towards our yard. The first heavy down pour and I noticed there was a stream of water halfway up my knee between the neighbors house and ours pouring into the cul de sac. We lost electricity and the sump pump stopped. The water came up through the sump pit as the ex and I argued helplessly watching the water rise. Insurance covered the loss but it should have been taken as an omen.  

Shortly thereafter MCI/WorldCom dissolved into the largest bankruptcy in American history at the time. No surprise the CEO, Bernie Ebbers, was a fraudster and the once Wall St. darling crashed and burned laying off 40,000 employees. I say no surprise because there was no other company I knew of that had so many people that no one else would hire as employees at that pay rate. The company’s lavish quarterly and annual awards contests were world class and the company only promoted from within. It was a genius idea but a scam, none the less. This left me unemployed again with a mortgage, two little kids and a wife finding less and less reason to be married to me. On top of this, the ex was having some issues with postpartum depression and our arguments were frequent and loud. The marriage was in trouble.
 

The exit with the ex wife burst like a zit on the entire cul de sac. Once I told her that I wanted to start my own telemarketing company it was days later she told me she wanted a divorce. I really wanted to keep it together but she was having none of it. She was also an emotional wreck and the lack of my income only amplified all the drama of the previous bankruptcy in her mind. She needed safety and security and I knew what I was best at was telemarketing. Some other guys from work had started a telemarketing company and some other supervisors were also putting together some of their own crews on the phones selling various services. They were doing well right out of the gates. I wasn’t quite sure what we were going to sell specifically but the idea itself was enough. She pulled the plug on me. It was my mistake to believe that success was going to solve all my problems. It was also my mistake to expect her to have the same risk tolerance I do.
 

The final straw was her living in the basement until she found an alternative place to live. One day I came home from somewhere and she was on the phone with her sister telling her what a loser I was. I had enough of it by that point. I took the phone from her and told her sister that she would be calling her back later. I said that was the final straw and she could take all her stuff to a hotel I would pay for until she got an apartment. Her wonderful sister called her parents and told them I was attacking her. Nothing could have been further from the truth. I was loading her clothes up and personal belongings into the old Merceds station wagon. I come up the stairs with a basket of clothes and was surprised by her 70+ year old dad standing at the top of the stairs with one of those old, short leather black jacks the cops used to carry back in the day. They had a piece of lead sewn into the leather to thump a bad guy. “Where is my daughter?” He yelled in a panic. She was sitting in the kitchen unharmed. He raised the blackjack like he was going to strike me and I shoved him at the top of the entry way into the garage door he came through. There were two steps down to the garage floor and he fell down them onto his wife and on top of the recycle bin. “He is crazy. Call 911 !” He shouted from the garage floor. She followed her dad’s instructions and sure enough they came.
 

One would think there was a three alarm fire at the house from the response of the fire department, ambulance and police cars that filled Jomar Court with their lights. All the neighbors, of course, came out to see the action. I explained to the officers there was not a hair out of place on princess and never has been. There was also a cornucopia of prescription drugs in the cabinet all prescribed to her that may have a lot to do with the behavior. The dad was a religious zealot that entered my home with a weapon and needed to be disarmed.” I was handcuffed in front of our crying children and stuffed in the back of a cruiser like a scene out of the movies. The cops got her side of the story and then got back in the car. I was told they had to take me in but there would be no charges filed. The law is designed that way to protect women and I understood. I was booked into the Hotel Linn County for a night stay. 

That night? Jesus. As they were taking my mugshot this old, white, drunk, homeless guy was going fucking nuts in the booking area beside me. I think he pissed or shit his pants and was freaking out. The cops had to secure that guy first. The drunk tank already had a handful of guys in there in varying degrees of intoxication. When the cop returned I asked for my own cell and they gave me one as I was not intoxicated. The guy that was my cell mate for about an hour, however, was a young guy they brought in wearing the suicide prevention jacket. It was a dumb white kid. I asked him what he did. He told me he wrote a letter to the president and said he wanted to kill him. I asked how they figured out it was him. He told me he signed the letter. The next morning I was sitting there waiting for the video judge in my orange jumpsuit with a dozen other fine citizens of the community who were innocent until proven guilty when the cop shouted out my name. “Free to Go. No charges filed.” It was over.
The pimple had burst. Next came the scarring.
 

I started the company with the idea of setting up appointments for insurance and financial planners. I knew the reason I failed was not that I did not try hard or did not pass the exams. I failed because I ran out of people to talk to primarily. I also knew deep down there was a huge attrition rate in the insurance and financial industry itself because it was 100% commission in most places. Sales reps always needed new leads. They could do the calling, or we could do the prospecting calls for them. We were not going to call people from Iowa. They didn’t have enough extra cash to make it worth our time. We went straight at the big cities and the big carriers with spams, voice mails and outbound conversations from three Voice Over Internet Protocol (VOIP) lines. The numbers could be programmed to show our area code as coming from anywhere and could be changed on the fly. To the people we were calling it looked like we were calling from Schaumburg, Illinois. Nope, it was initially Rat, myself and The Kank that started it in the basement on Jomar Court in Cedar Rapids in 2005.
 

I was correct in my initial assumption and the business went bing, bang, boom…What started off with some beers, a bong and a dry erase board noting calls made, sales goals and contests like we did at MCI/WorldCom grew quickly. I needed an office for a couple more guys. The next two guys were Sanchez and Flounder. They were two guys in their late teens when they worked at MCIWorldCom. They were natural born hustlers from broken families with previous run ins with the law. Like most degenerates at MCIWorldCom, they were going nowhere fast until they realized they could make adult money on the phone legally with their verbal talents. When we started picking up steam I picked up a cheap office downtown Cedar Rapids on the fourth floor of the old Guaranty Bank Building. Flounder and his girlfriend Brittany later moved into the basement of the house and I also picked up some rent money. The good times last a year or two. I was up to half a dozen guys at work and I was making thousands of dollars a month in cash. In 2006 we made $382,000 and I thought I was just around the corner from the big league. 

It was Brittany’s friend that was also the first girl I had sex with after the wife left. I don’t remember her name but she was in her early twenties. It was strange but a reminder of what was missing in the house. I had the kids about half the time and they knew all the guys from work. The kids still had their bedrooms and they went to the same school but their lives were different now. I failed to provide a happy family with their mom and at least half of that was my fault. They seemed OK with it but it was tough on me. I also didn’t want the kids to think I was a deadbeat loner so I started the online dating. 

Not to be forgotten was the Bucky the Turd Fish episode. I had a fish tank built into the wall in the basement. I bought a plecostomus fish to clean the tank. He got big and died. I flushed it down the toilet and it made it past the first kink in the toilet but wedge in there and did not go down the drain. Then it started to decompose and stink. This was after a weeks of people using the toilet too. It stunk so bad in there we couldn’t even use the damn bathroom. Was it a turd stuck in there? I paid Flounder $20 to take the entire toilet into the front yard and dig it out. He did and out popped a decomposed Bucky that stunk to beat the band. The neighbor just shook their head.
 

Unfortunately, Flounder was a young alcoholic. He would get shit faced and become mouthy and aggressive. He was neither a fighter nor a lover. He never knew who his father was and the mom was in rough shape. She was a fat, older woman that lived in a shitty apartment. Flounder was sleeping on the couch. He said some skinny, dirtbag, black guy would roll up in the middle of the night and go into mom’s room and bang her. Flounder and Brittany lasted a few months in the basement. Flounder got shitfaced one night and broke some of their furniture and was pushing Brittany around. I told them it was time to move out. I never saw them again.
 

The end of 2006 we had a party in the house with the guys from work. It threw out a bunch of money, we got drunk, played bobbing for apples for cash and the mad mob for a fist full of cash thrown in the air. This was the max amount of hot air that could be jammed in my balloon, right? Nope. There were also several women off the internet that I went out with on dates with. After a few weird ones I met a teacher out of Iowa City that was 26 when I was 37. We hit it off right away and she was a great girlfriend for a few months. She gave me the confidence that things were going to be OK with the kids and I. She didn’t tell me she was banging this other guy when she went down to Guatemala though. After we broke it off there were some strange one night stands, some odd dates and some straight up flops before I met another love. 

Unfortunately, for me, the flood of 2008 devastated the city of Cedar Rapids and we were right down town. I would have got totally screwed as we didn’t have any water damage because we were on the fourth floor. But the entire downtown was closed off for days. All the clients we had got zero and were pissed as they could see their checks floating down the river on CNN News broadcasting locally. I had to think quick or I was going under fast, again. FEMA came to town and was passing out checks to damaged business owners. I explained we had our make believe servers in the basement of the building and our entire business was destroyed. The guy signed off and I took that to the bank and got a $50k grant to keep the business open right back where we started, the basement on Jomar Court.

The 2008 flood also rocked the basement again. I had installed a backup battery to prevent an overflow if we lost power. We lost power again but it was for hours. The water was pouring into the sump so fast the battery drained within an hour and the basement ended up with about twelve inches of water. Insurance paid for it again but I had to make some huge changes. I hired a guy with a skid loader to create a berm around the house and funnel the water around the house. I also had a dun truck full of gravel dumped in the drive way and tiled out the around the back of the house. The heavy rains now between the house and the neighbor’s would be knee high like a stream through the yards.
 

Barbie was a great girl I also met off the internet. She was the 40 year old virgin from Northwest Iowa. Her family were some sanctimonious religious nuts from Sioux Center, Iowa. She left it behind and got a Phd. We hit it off right away and I thought she was the one. I was wrong. It lasted a few years. In the end, I just could not play second fiddle to Jesus and her dad and his million dollars. He was a tightwad, bible beater from Nowhereville, Iowa. I needed her to step up and tell him to step off, but no. He was the over protective dad that was just a cheapskate in real life. He was a small-town buzzard, signing in the choir at church on Sunday and kept a white knuckle grip on every dollar he ever saw. He figured out pretty quick to spare me the Jesus bullshit. I was banging his prized possession after all. It was all I could do not to tell the guy to back the fuck off to his face. She and I had a good run there for a few years but when the times got tough she made it clear she just could not help me out. Why? Well, daddy was still managing her money at 43 years of age. Imagine that. Unfortunately, for both of us, I always choose love over money. When I offered her 10% on a $10k loan to fix up the house she declined. Nope, a car dealer would extend more credit than the woman I was in love with. Cool, just not with me. I ended it. I was in a tough spot too. Had I not done that? That fucking ol’ boy would always be there in the background snickering about his stack of chips and calling the shots. Yeah, I was the first in there to disrupt all that religious mental masturbation for her. But I can’t blame her as much as I would like to. People want results. I had no results, no cash and nothing more than the next business idea being started with less cash than the last one.
 

It was 2011 and the final year I was required to carry Ashton Danbury to be forgiven of the $50k FEMA loan. I had three phones running in the basement. There were a variety of personalities that roamed through the basement on the phones. I picked up a mechanic’s wife who worked on my Jaguar. Her name was Amber something, a dumbass. She was a nut who was snorting lines in my bathroom. She was replaced by Cory who was baby mama to some deadbeat black guy from Cedar Rapids. I ended up working with her sister a couple years later at Popoli Italian restaurant in Cedar Rapids. She looked just like Cory but said her sister was a dead beat. Butt Darts was a good egg we picked up that did some good minutes on the phone in the basement after the flood. There was also Dustin Frondle on the phone a few days on the phone. He was another white trash dumbass from Cedar Rapids who thought he was a hustler. He used to work on the phones at MCI/Worldcom. I remember he skipped work one day so he could go to Target and buy some new Hot Wheels cars. I fired him on the spot. He got shot and killed a few years later. Surely a drug deal that went south. There was also Ty Downs. He was a black dude I suspect was hooked on crack. He was a supervisor at MCI/Worldcom for a minute. He got a paycheck and disappeared for days. We had a picture of him wearing his pimpin’ clothes for a Halloween party up on the wall. How fitting. He was dead a couple years later too. We put in a Tornado foosball table and run contests for hot calls. Give me a live one on the phone and ya get to play me in foos ball for $20 if ya won. . I turned the old calling room into a jam room with a drum kit, my guitars, amp and a PA system. I rocked in there many times with ol’ Doc Mike on the drums. 

There was also the $20 bet with Cody that he could pin anyone in the boiler room. He was a little guy but was a state champ wrestler in high school out of Des Moines Lincoln High. Booze and drugs prohibited him from parlaying that into college or a good paying job. He pinned Sanchez in a minute so I had to try it too in the front yard, of course. I grabbed him and threw him on the ground. I pounced on him and had no idea what to do. I could not punch him, kick him or bite him. He figured this out pretty quick and snuck out somehow and got on top of me. I could have beat him if I would have gotten violent but this was not a fight. I lost $20.
 

There was also Cody’s stupid ass drummer neighbor. This idiot was some guy my age that lived in his apartment complex. He told Cody and Cody told me that was a drummer. He came over to the house one time to jam and it was comedy. He was a redneck straight out of the trailer park that was wearing a motor oil racing jacket and sounded like he had about a 9th grade education. We jammed for a little bit but he was not the guy. It was a short jam and I made up some bullshit to get him out of the house. He left with the quote, “Well, back to drinking, fucking and racing. Well, two out of three ain’t bad.”
 
At the end of 2011 I closed out Ashton Danbury. The boiler room was done. The experiment worked but the truth I found was the ratings and reviews on the internet were beginning to take hold. 95% of the clients got zero and it was just a matter of holding their hand through the zero results. Most were pissed. Some went to the internet to leave comments on message boards. We had an extra line in the basement with a phone number that could be changed in minutes. Guys would ask for a reference and we would give them that number. I would play along like I was doing great with them. That was enough convincing to get a check. But their zero results would be posted and guys that were already worried about getting burned not he phone would see the comments and not send a check. Even if they did send a check the problem was we could never get them back to try again usually. I had to change business models and I did. 

I started Navy Diver Challenge out of the basement in 2008 and kept it going. It was an event I created after being invited out to Coronado to a reunion with an old navy diving buddy. The first event was small but we had a couple SEALS in the event. We put it on the internet and began to get a little following on social media. We started calling and emailing every business we could find in the large sporting stores for donations. Then the bin Laden raid went down and everyone wanted to be friends with the SEALs. We were in the right place at the right time. We would send a link to our videos and several opted in. We auctioned off the gear we were given at the events in San Diego, Iowa and Virginia Beach. All I did was switch the business model from insurance and financial geeks to any type of company that had a relationship with the military. We made up an email and blasted it to all of them and then stored their info on an excel spread sheet. Soon the basement was packed full of gear. We had canoes, fire extinguishers, watches, knives, boots, scuba gear, climbing gear, clothing, you name it. Every day the UPS and Fedex trucks stopped into the cul de sac.
 

It the neighbors thought I went off the chain when we started testing some of the gear we got. We attached a zip line from a tree in the back yard to the pergola on the patio deck and then took turns zipping down it. We had Palmecci try and break into the house with the professional lock picking donation. He had two minutes or he got maced with the pepper spray donation. He lost and got smoked in the front yard. There was the boot burning test. A company sent us about thirty pair of boots that sucked. We cut a pair up with a saw and lit them on fire in the garage during our testing and then posted the video. The air soft machine guns had to be the best though. They shot the plastic BB’s at ya hot enough to leave a little mark. We chased each other around the house blasting each other until the guns were beat and the ammo exhausted.
 

There was the unfortunate fight with my step brother. We started having dinner and drinks with the ladies and my dad. Those guys left and we kept drinking wine. He got drunk and started up with the victim stuff. I told him a couple of the guys had reported back to me they saw him out in town with the same crying in his beer type whining. It old him if has some issues he might want to see a psychologist. He took a swing at me. He barely touched my shoulder but he meant it. I reacted and dropped him with two sharp blows and broke his nose. He tried to blame the entire thing on me to my dad playing the victim again event hough he started it. We all have our shortcomings but the last I heard from him as he walked out the door was, “This stays in the family.” Yeah, that lasted until he sobered up and went to the hospital. The public intoxication charge would have been his fourth to go along with two drunk driving charges and a drunken boating charge. This meant jail time for sure if the fops got called. So he went home and sobered up first. Then he went ot the hospital and then he called the cops to try and blame it on me so I would have to pay the medical bills. The cops came over and said it was my word against his. He should have known this too. Case was dropped. I haven’t heard from him since. It bothers my dad this upset the family. In the end, I know different people have different issues. Like my psychologist told me back in the day, “Everyone is usually willing to listen but very few can actually help.” I stand by the comments and my response to the behavior that evening. Hopefully, one day he is honest with our father and his wife about exactly what traspired. However, it would require him to give up on the victim role he has played for years. I forgive the guy and wish him the best. 

It all came to an end when I lost the lengthy fight over refinancing the house with the bank. The girlfriend bailing out on me I wasn’t counting on either. I asked her for help as a last ditch effort to fix up the house before I put it on the market. The savings account was paying 1% and I offered her 10% interest. Not good enough? You can’t say I am not worth it to my face? Done. It was a tough call but if I would not have called it off it never would have ended with the Bible beatin’ daddy in the background calling the shots. Wrong guy. That left me with nothing more than a weekend cooking job in Dyersville and that was not enough income to move the needle. The banker told me times had changed with the underwriting since the American mortgage implosion post 2008. I needed to show more income to get the house refinanced or access any capital from the equity. No one seemed to believe in me it seemed. 

The debacle in Dyersville unfolded right around this time too and that was the final straw. There is a story written about that event itself. There was literally a sting operation that started out with an undercover cop watching me across from the house and following me all the way to Dyersville I learned in discovery of the case. I needed a lawyer and cash in short order. The ex wife knew it was a tough spot to be in but cashed out an insurance policy she kept from back in the day when we were married. I paid the defense lawyer and put the house up for sale. Retaining the expensive defense attorney, The Hammer, was a smart idea and the case ended with a fart. The house was subsequently sold through a buddy of mine who was a realtor at the time. I walked with a net worth of $17,000 at 45 years of age. After all the cash, prizes, telemarketers, women, wine, song and drama in the house it was finally over.
 

It was a difficult loss for sure as I moved into my buddy Summy’s basement. He was our long time computer guy that that used to work for me. He has known the kids since they were little. Shortly thereafter I got a drunk driving charge in Iowa City like a dumbass and lost my license. The kids still would come over every other weekend and sleep beside me in a bunk bed in the basement. Having the ex wife and her husband driving the kids down and picking them up knowing I was living in some guys’ basement like a deadbeat was rough. College graduate or a deadbeat? I could hear them shit talk me all the way there and all the way home in my head. Truth was I lost. I deserved it. There are consequences for failure.
 

Looking back, it was more my ego looking for an identity. The success came from the creativity and always will. The failure came from the wrong purpose. Once it was just us and no one else around to keep the guard rails in place it allowed us to free lance with the business model, and bend the rules. However, the wisdom of Japanese philosophy Ikigai easily explains why both ideas failed. Although we were popular for a minute the product or service has to be something the customers want, something you are good at, something we can make money at and something that makes you happy. It has to be all four or it will not yield optimum results. The customers with Ashton Danbury didn’t want a bullshit lead service and the NAvy Diver Challenge didn’t make enough money. I had to pull the plug on both and ended up working as a cook in a restaurant. These were humbling failures. Everyone that knew me also knew I failed, again. These were tough days.

It seems a while ago now. I have a brand new home in West Des Moines that is even nicer than the old one on Jomar Court in Cedar Rapids. A variety of other crazy events unfolded in the subsequent 10 years and I ended up back on my feet. There were a lot of times in the old house and a lot of people who went in and out of the doors. These were not all the events that went down on Jomar Court but it gives ya a good idea about the times.  

Docs,

After reading Financial Toxicity and Cancer Therapy (A Primer for Radiation Oncologists), your paper, I want to thank you for addressing what most in your profession will not. The ridiculous cost of cancer is simply one chapter of the failure in American health care. I appreciate the opportunity to read how these thoughts have been formulated by some highly educated experts in their field. One of these experts is in the process of trying to cure my rectal cancer. The specificity of the treatment regimen is something I am poorly qualified to discuss. It is just outside my wheel house, obviously. I am in your hands and regardless of what I think about the economic, financial and political ramifications of how we administer health care in America I am truly appreciative of your services. I can also preface this by saying every single person involved in the treatment of my rectal cancer has been top flight in my personal opinion.
 

However, this piece written is about affordability of your services, or lack of. I got the feeling it was more scholastic in defining some of the issues. Instead of offering measurable steps in how to solve the underlying causes of Financial Toxicity (FT) foisted upon unhealthy, uninsured and low income Americans the piece merely exemplifies it. Overall, I believe it would be more compelling to exemplify the causes of (FT) in healthcare in America by comparing and contrasting it with the Swedish health care model and Adam Smith’s Wealth of Nations (1776). The Scandinavian health care models are similar, however, I lived in Sweden and most familiar with their system. The solution to (FT) in America is multi faceted but the blue print is already there. The Scandinavian health care systems have been running efficiently for decades. Scandinavians also consistently are anchored at the top of most surveys regarding the healthiest and happiest people in the world. America is the wealthiest country in the world and never near the top. China has almost four times our population. Healthcare is free in China to all Chinese citizens. China has been the fastest growing economy for the last couple decades with free health care for the world’s largest population and it is communist? It is much like my Swedish buddy told me on his first trip to America, “It really is the best place to live if you are healthy and wealthy. If you are not? It is not that cool.” I will return to the Swedish model later as part of the solution. 

Smith’s work is the playbook and bedrock of capitalism in America and a great place to start. This book laid out, labor, wages, property rights, taxation, etc…Smith is famous for the Invisible Hand theory that can be best summarized by everyone acting in their own self interest and mutual interdependence. This increases the quality and drops the prices in almost all goods and services. College and the internet told me Smith’s concern was that economic inequality distorts our sympathies. Unfortunately, this alludes to admiration of lifestyles of the rich and famous and demonizes those most susceptible to (FT). This mentality, protocol and policies in place to enforce it are misguided at best. This American health care model serves to undermine both morality and happiness of those most in need of the services. Smith’s model is outdated to say the least. All the money and power have ended up at the top. The results; measured by the national health care metrics, happiness and economic freedom? This is a flop for those unhealthy and most susceptible to (FT). Oddly enough, about 100 years later Marx and Engels wrote the Communist Manifesto. They predicted capitalism was a phase. All the people with no cash/proletariat/labor didn’t have enough in common to agree on the good of the whole. Those on the bottom of the financial totem pole would rise up and demand change. This has also happened throughout history for various reasons. The rich people have been screwing over the poor people since money was created. A fool and their money are soon parted….no college degree needed.
 

The reality is the piece you have written reminded me much of the Minnesota Viking Super Bowl Committee talking about perpetuating the current strategy for success. By most metrics they are financially successful. Everyone at the table is a millionaire and the owner is a billionaire. I have also been a life long Vikings fan and watched these jokers fail in every way imaginable as a sports franchise. There is no seat for me at the table though. However, the stadium is full every Sunday, the profits are astronomical and the prices across the board are at nose bleed levels on everything for sale within the stadium and online. The key players salaries are tens of millions of dollars and the other 80% of the team deal with half of the rest of the money. The tax payers are on the hook for hundreds of millions of dollars for the stadium to start with before it was even built. Sure, it looks beautiful and I still watch the games. What is wrong with this scenario? How about the freakin’ results, fellas? Of course, one is entertainment and one is health care…..or are they? 

The funny part of this analogy? When my Viking favorite is lying there on his back on the field and the highly qualified and compensated medical team run out and gathers around him. “Wow, Latrell, looks like that shit hurt. Imagine that, 6’5” 280lb. guy just piss pounded you.” As a medical professional, what is the obvious thing to say here if this were your kid? “Yo, son, ya gotta stop playing this game. The brain collides with the inside of the skull from inertia. The helmet is a gimmick if not the weapon. You will end up even dumber than you are now and without the fat paycheck here shortly. Do yourself a favor and take the money you got from the contract and go back to school or just put it in the bank and live well below your means for the next decade. Thank me later.” Nope, it is the opposite. Everyone just wants him back in the game; the fans, the teammates, the coach and himself. So we justify mending Latrell only to throw him back out into the exact same high risk environment that caused the injury in the first place. Subsequently, the medical professionals on the field go against all their training and perpetuate the problem by trying to resurrect the injured players only to run through the sequence again. Why? Simple, their own self interest.
 

If the medical professionals were actually effective at their jobs, and affective on the overall health of Americans in general, the number of patients would subside and the emphasis would change to mostly preventative healthcare and maintenance, yes? Nope, the cash is made in treating the symptoms, not preventing them. Today our neighborhoods, streets, schools and prisons are filled with obesity, cardio vascular disease, dementia, diabetes, mental health cases, addicts, alcoholics, criminals and degenerates. Voila, for profit health care. The rest is a traveling show of plausible deniability, deflection, legalese and justification. No other first world country has such terrible healthcare results within its population.
 

But where does this health care jerk off for the masses begin in America? There is an equal amount of culpability between the American Medical Association, politicians, universities and insurance companies to go around. Let’s look a little further into how each of these participants is equally to blame for the terrible results of American healthcare. The plausible deniability is woven deeply into each participant for the same reason, profits. Ask any of the those administering health care if their needs to be change and the vast majority will say there is….as long as their pay does not go down by the changes. All will see some failure in the process of facilitating the actual health care to patients. Unfortunately, the scrutiny on their own over inflated charges, value and failures draw little to no scrutiny. In short, the individual interest of the person providing the health care takes precedence to those needing it.
 

Clearly, there is also little concern by the AMA to mitigate the exact same behaviors that lead citizens to becoming patients. The simple function of this equation would mean less office visits and procedures performed. This means less money. There is no politician standing up for those who have nothing to donate compared to some of the deepest lobbying pockets in America. The citizens are bombarded with unhealthy junk food commercials, knuckle dragging stupid credit card commercials to pay for any experience to keep one entertained and then advertisements for gimmick supplements and pharmaceuticals to fix you when you are not getting the results out of the life you deserve. It seems pretty clear by following these advertisements Americans are being conditioned to believe they have the freedom to be as careless as they possibly can be with no consequences. However, when it does fail there are doctors there to fix it…..as long as you can pay.
 

Where is the American Medical Association, the association of our finest medical minds on Team USA, to stand up to this messaging? The message is quite simple, “Hey, can we stop exploiting our people into bad behavior that we know leads to long term consequences?” Crickets. One look at the AMA website currently and it is part scholastic, platitudes issued as public statements that are meant to deflect liability lawsuits and commingle marketing simultaneously…. instead of affect meaningful change. “The most important subject facing the AMA is medicare reimbursements?” All of this is under the guise of the patient deserves and needs the absolute best health care in the world. There is not a peep about the cost of said care. The name of the game is to never stop the cash flow. All businesses have this ambition. The majority of doctors in America have opted for there profits over professionalism. Masquerading as intellectuals, business professionals, educators and healthcare professionals in an echo chamber with each participant allowing their own individual self interest to supplant the interest of the greater good of the whole. Instead of market forces determining the best prices, best quality and most value, it is a rigged system. Those who are in most need of the services and those with highest probability of facing (FT) are the exact people suffering the consequences because…..they cant afford your services.

Americans are some of the unhealthiest and fattest people in the world. Why do we allow low income people utilizing SNAP benefits to purchase sugary drinks, high fat, high salt and ultra processed foods on Uncle Sam’s dime? The science is already in. We know that there is a direct correlation between intelligence, poverty and poor health outcomes. Millions of Americans are not smart enough to feed themselves healthy food. This is sad but true. This seems like an obvious place to see improvements in the health care statistics. Also seems like a damn good place to start taking action. Where is the American Medical Association leading the charge to stop this government financing of unhealthy food? Crickets, again. Why? It is quite easy to connect the dots and draw a direct line to future health consequences. These unhealthy folks are quite simply the next customers. Where are the senate committee hearings and investigations, exactly like tobacco? These dumb, fat and unhealthy folks make paying customers for the whole medical industry; general practitioners, big pharmaceutical companies, medical devices, specialists, continued care, supplements, etc… Once the unhealthy are flat broke they get medicaid, or turn 65 and get medicare. These patients themselves don’t care about price either because they are not paying for it. The plausible deniability? American freedom allows people to eat whatever they want and that means junk food too. “It’s too complicated”, ” It is political”, “ I am just a doctor.” No, it is simple. Make a stand this is bad for our people. Professionalism over profits. On the AMA website right now as I write this is “Why Medicare reform is our top priority.” The speaker goes on to say their reimbursements have declined 29% since 2001. This denies patients access to high quality health care. Really? The other way of saying this is, “We prefer to work with the wealthier folks who have private insurance or cash, not have some government entity tell us what we can charge.” 

Where is the AMA to protest the dumb pharmaceutical television commercials? These have gotten beyond stupid with, dancing and twirling fat people singing about diabetes drugs or some severely depressed person laughing simply by taking a pill. It seems there are diseases literally invented to have a pharmaceutical to combat it. Each commercial always has the token, “Ask your doctor now.” What are the costs of these commercials? This is inherently a substantial cost of the medicine itself. The people that see these learn nothing about the actual drug other than a laundry list of potential side effects and some fine print on the bottom of the screen. The entire process is controlled by sales reps with samples who meet with doctors and pharmacists. The reps already have all of the doctors prescribing data on proprietary software. This tells how much of they are selling, what brands, pricing and historical prescribing information. What could possibly go wrong?
 

This behavior is not tolerated in the vast majority of first world countries either. Look no further than the Sackler family behind Purdue Pharma OxyContin and the opioid crisis. A pathetic multi billion dollar scandal that involved many of the C suite executives being indicted on fraud. The massive donations to schools to verify the quack science for the family name on the buildings, now removed, was repulsive. Massive settlements to states over this scandal have already been paid out. The Sacklers are not behind bars and their massive ill gotten fortune is protected by lawyers and laws. Why? They incorporated to limit their own personal liability while acting in the capacity of the company. The entire time they were siphoning off the ill gotten profits and in the end they accept no responsibility and negotiate a payout. Obviously, the OyxContin marketing had no purpose other than to promote sales. Was Purdue Pharma the only one abusing this process? Nope. National opioid settlements have been reached with several companies/defendants; Janssen, Cardinal, McKesson, AmerisourceBergen, Teva, Allergan, CVS, Walgreens, Walmart, and Kroger Co. All of them were operating on their own self interest and admit no guilt as part of their settlements.  

Americas universities are also in large part to blame for the (FT) across the board in health care. How much is the final tab for medical school? What is the premium on the malpractice coverage? I ask this because these are significant costs in the care provided and I did not see it mentioned in the piece I read. I notice there are no doctors advertising that their prices are also cheaper when their loans are paid off. The truth is the university tuition bubble needs to burst and healthcare is the best example of why. The reality is equally talented doctors in Sweden are trained for next to no charge and there is no malpractice. Their people are healthier because they are more educated and their culture does not promote excess wealth as a virtue. Sports are not part of academics at any grade level in their education model. Sports are viewed as entertainment and not a valid career choice. Yet, they still have guys playing professionally in the NHL and Premier League Soccer. How many Americans have gone too far down the road of believing they, or their kid, were going to be the next professional athlete? How many teachers looked the other way on failing students simply because they were an athlete? The reality is colleges are not non profit organizations as they claim. They are billion dollar organizations parading as non profit educators to the masses. Sure, the science folks get a good education on campus but the liberal arts students get soaked with worthless degrees that no employers are looking for. Half the football and basketball team scholarships are dropped as players realize they will not be going to the pros and the African American studies degree is wanted by no employer on internet job postings. These are the exact next generation of (FT) patients. They will be trying to determine if they pay the student loan or take your over priced medicine in a few years. Meanwhile back on campus, the construction never stops with every building named after the next billionaire philanthropic tax gimmick emblazoned across the front. The foundations have swollen to over a billion dollars in many cases and yet tuition never seems to go down. There is zero getting out of the student loan either. Yet, there is absolutely no accountability from the universities for charging millions of students exorbitant amounts of money for knowledge that cant be parlayed into a self sustaining career. This is called eating your young and creating minions.  
 

The “No Fault Compensation for Medical injuries” article in the July 2001 Journal of American Medicine compared the healthcare systems of New Zealand and Sweden for comparative purposes. It concludes that there is no imaginable way this type of health care could be implemented in America without expanding a massive social safety net. This is correct. But to go on and state that patient safety has suffered severely because of linking compensation to the accountability of unsafe health care providers is a bit rich. Considering Sweden has one of the best health care systems in the world. New Zealand is no health care slouch either. This is more American bravado. The correct conclusion would be, “Our current system is a failure that over compensates doctors involved in American health care. There are many variables for this but we should lobby for drastic changes because a significant portion of our population can’t afford our services and are in terrible physical, psychological and financial shape.”
 

It is impossible not to mention the insurance industries stunts in this fiasco. The term adverse selection should be repeated throughout your piece but I didn’t notice it. This is the insurance industries term for people that are too sick, old or unhealthy to be offered coverage. Actuarial science creates the sliding scale of the cost per unit of insurance based on a multitude of health factors but each of them adds to the per unit cost. The people that have pre existing conditions are eliminated and thus destined for (FT) or pay in cash. This process is designed to charge the most for the people that have the highest probability of actually filing a claim. Add on top of this the publicly available information on insider trading on health insurance stocks and this seems unethical. As of the writing of this piece the Those at the top of these organizations were just smashing it in 2023. 

-United Health Care CEO Andrew Witty $24m, 

-CVS CEO Karen Lynch $21m

--Molina Healthcare CEO Joseph Zubresky $21.5m

-Cigna CEO David Cordani $20.9m

-Centene CEO Sarah London $18.6m

- Humana CEO Bruce Broussard $16.3m

How much health care could have been provided to those suffering (FT) with the over $120 million in health insurance CEO compensation alone? The insurance companies are directly responsible for their part because they are foisted upon the employers of America who are burdened with choosing one of these companies to offer coverage to their employees. Not only are most employers not experts at insurance they are also required every year to shop the coverage. The reason for this is any claims that have been filed can be calculated in to next year’s premium. The other employees absorb the increase in premium or quit and seek a job with better insurance. No one likes this; employers, employees or health care administration staff dealing with all the various insurance companies. This process directly leads to discrimination in hiring without a word being said. The unhealthy employee increases the cost on the otherwise healthy employees. I personally am going through that right now. Do I tell the prospective employer I am taking radiation every day and need the morning off? Then it will be surgery so I will need another week off? Nope, the resume goes right in the trash with a smile and a subsequent email that says we are moving forward with other candidates.
 

Still more pathetic is the fact that medical debt is one of the primary reasons people file bankruptcy in America. Not only do the doctors charge rock star prices on everything, they turn the debt over to collectors to pursue you. Any debt over $500 can also affect one’s credit score. With background checks and credit checks involved in employment offers this immediately puts anyone in (FT) behind the 8 ball. This is the dirty truth about American healthcare long after the person is out of the hospital or completed their care. The cold hard truth here is wea re going to charge the most expensive prices in the world for the care we provide and if you use it we will pursue you all the way to bankruptcy to ensure we get paid. Shameful. Easy to justify it at the top. The docs earned their way. Good for them. I have no qualms with doctors being the highest paid professionals in America…..provided the results are there to back it up just like any other business model. “Sorry, pal. No guarantees other than we ask for proof of insurance before we treat you. No refunds either.”
 

The most difficult pill to swallow in this entire piece is the political corruption. There is no voice for the millions of poor, unhealthy, low IQ and worse. Their presence is the byproduct of a system that does not yield the best results for the masses. Their growing numbers also indicate the system in place heretofore is a failure. Politicians need money and the poor, sick and dumb have no cash. Most of them do not vote either as they are simply trying to survive in a system that has failed them. Politicians can speak all they want to the problems we face but until there is meaningful campaign finance reform their self interest is re election not healthy Americans.
 

Let’s bring Sweden back in to the picture again. In America there is limited free education, scholastic or industrial, that can lead to certification. In Sweden there is a system called Akassa. We do not have this. It is lifetime job training. As long as you can pass the exams you can be trained for anything pretty much. Those in-between jobs and training for their next via the Akassa system also receive a job training stipend. In short, their society understands health care and education come in myriad forms throughout life. A person’s dignity is important. It is a commitment to integrating all into society as productive members. What is more important for societies’ prosperity than to offer its citizens free health care and education? In addition to these benefits there are several months of paid maternity leave that can be split by both parents. The nurturing aspects of early human development are crucial in emotional and social development. The guaranteed pensions and state sponsored nursing homes are integral in keeping what wealth that has been earned in the family and hands of private citizens.
 

America’s poor and dumb’s (FT) will spill over into the greater future economy at large even more so than now. The current solution? It seems the AMA motto is “Take as much money off the table as possible without getting sued. You deserve it. Shit on socialized medicine at every turn or our personal pay checks will be headed south. Promise no results from our expensive treatment costs. Prices never go down and have zero interaction with the patients outside of the care facility. All issues go to HR and the legal department. Deflect all blame on costs towards the cost of education, insurance and business expenses. NEVER TELL THE PATIENT HOW MUCH YOU EARN OR YOUR PERSONAL BENEFITS!” Ever wonder why? Yeah, everyone would know they are getting screwed and want to pay less. The medical personnel working at the state universities have their salaries published so the average amount of homework can see we have some hypocrisy here. On the flip side, the poor and dumb? These individuals have to get down to bankruptcy level to go on medicaid or wait until they turn 65 to go on medicare. The nursing homes are mostly not paid for by the government and the Medicare and Medicaid systems currently are rigged to limit costs and are not in the best interest of the population at large. Quite simply, look at the overall results of the general health of our people. When is it acceptable to step up as an MD, or national association of doctors, and demand these gimmicks stop? Crickets. Why? Again, because those same doctors’ invisible hand encourages them to continue to charge the nosebleed level prices and enjoy a life of luxury. Don’t hate the player, hate the game. The default plausible deniability is that the system is just too complex to fix.

The Solution

 The answer is very simple; social democracy, not socialism nor communism. This ridiculous line continually drawn and pumped by right wing partisans and the ignorant is constantly first brought up in any conversation about sweeping changes to our health care system. Social democracies are just like America except they have social safety nets. They vote in longstanding democracies, they have free markets, privacy laws, millionaires and billionaires as well as insurance, courts, hospitals and medical schools. They have higher taxes too. Still doctors in Sweden take home approximately $8,000 to $9,000 a month. They have no student loans to deal with after graduation. The malpractice insurance is taken care of by the state’s Patient Compensation Insurance. This is administered at a fraction of the cost of the overall healthcare compared to American malpractice. The education is directly tied to job training. In America, the universities have exempted themselves for any accountability in providing education no employer is looking for. Primarily, the college of liberal arts has mostly been supplanted by Google and Wikipedia. There is no one at the registrars office trying to steer tuition paying students away towards industrial trades. The student athlete majors and curriculum have long been the subject of ridicule and folly. Why? The universities’ invisible hand cares more about making money in the short term than the long term affects of putting Latrell through school with a degree no employers are looking for. Then to put him out on the field as an incentivized student in what everyone clearly knows is a very dangerous sport? It is for the money. 

  If you were to ask all the families in America, the world’s wealthiest country, “Would you accept your personal taxes going up 15% and 30% on everyone earning over $300,000 if you received the following benefits; 

-almost no cost lifetime health care

-lifetime almost free education

- very low cost child care

- almost no cost nursing homes

- months of paid parental leave

- guaranteed pensions

- unemployment insurance

- restricted firearm ownership

- better public transportation

- better quality food, less junk food consumption

- elected officials in legitimate elections

- legitimate courts and judicial process

- government regulation the majority feel is effective

- top scoring health and happiness scores in most all international surveys 

- lifetime job training

- entrepreneurial and egalitarian spirit in heart and law

- strict respect and regulation for the environment and agriculture?”

The vast majority would say yes. Specially, if they got to visit there first and see how it played out in the long run. Who would say no? Obviously, all the “professionals” in America making north of $300,000. This would be a titanic shift in America that is unimaginable without a collapse of capitalism itself.
 
Oddly enough, about 100 years after Adam Smith’s Wealth of Nations Karl Marx wrote in the Kommunist Manifesto that capitalism was a phase that ultimately will culminate into socialism., primarily because the population won’t be able to agree on anything. It truly is greed that is the invisible hand. Adam Smith was writing before there was a steam train on the ground and probably would make some heavy redactions to the work if he were alive today. Karl Marx is probably smiling in a grave but not 100% accurate either. There will always be self interest, but other than people’s family and their health it is their money that matters most….not the other guy. Kind of like the owners of the Minnesota Vikings; this year looks rough even before the season and the committee’s recommendations for winning the Super Bowl. This year is purple beer on game days and more platitudes about racism visible on television. Go to the same well and the water tastes the same.
 

When I look back 100 years ago on what they did for rectal cancer it was zero other than alleviate symptoms the best they could with what they had available. What will they think 100 years from now about how we practiced medicine today? I suspect they wont take the AMA’s current priority of higher medicare reimbursements over socializing medicine was best for the people. I am lucky. I am flying for free as a service connected veteran. I get the exact same treatment all the people paying out the nose are. The doctors in Sweden are using the exact same treatments we are in America. They have the exact same requirements for education too. The difference is their people are smarter as a whole about the needs of a society and the importance of equal access. Not every kid in Sweden ends up a doctor and not everyone is healthy. But what they are committed to is not having health care put anyone in (FT) and that means higher taxes on the rich and not tax gimmicks disguised as philanthropy for the ultra wealthy. In America, this will not happen as too many people have their grubby invisible hands in the pie. However, like the late Winston Churchill said, “You can always count on the Americans to do the right thing- after they’ve tried everything else.”